title: Clinical efficacy and safety evaluation of tailoring iron chelation practice in thalassaemia patients from Asia-Pacific: a subanalysis of the EPIC study of deferasirox.
abstract: Although thalassaemia is highly prevalent in the Asia-Pacific region, clinical data on efficacy and safety profiles of deferasirox in patients from this region are rather limited. Recently, data from the multicentre Evaluation of Patients' Iron Chelation with Exjade (EPIC) study in 1744 patients with different anaemias has provided an opportunity to analyse 1115 thalassaemia patients, of whom 444 patients were from five countries in the Asia-Pacific region (AP) for whom thalassaemia management and choice of iron chelators were similar. Compared to the rest of the world (ROW), baseline clinical data showed that the AP group appeared to be more loaded with iron (3745.0 vs. 2822.0 ng/ml) and had a higher proportion on deferoxamine monotherapy prior to the study (82.9 vs. 58.9%). Using a starting deferasirox dose based on transfusional iron intake and tailoring it to individual patient response, clinical efficacy based on serum ferritin reduction in AP and ROW thalassaemia patients was similar. Interestingly, the AP group developed a higher incidence of drug-related skin rash compared to ROW (18.0 vs. 7.2%), which may indicate different pharmacogenetic backgrounds in the two populations. Our analysis confirms that, with appropriate adjustment of dose, deferasirox can be clinically effective across different regions, with manageable side effects.
authors.affiliation: Haematology-Oncology Division, Department of Paediatrics and Thalassaemia Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand. sivvp@mahidol.ac.th.
authors.forename: Vip
authors.initials: V
authors.lastname: Viprakasit
authors.affiliation: Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
authors.forename: Hishamshah
authors.initials: H
authors.lastname: Ibrahim
authors.affiliation: Queen Mary Hospital, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Shau-Yin
authors.initials: SY
authors.lastname: Ha
authors.affiliation: Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Phoebe Joy
authors.initials: PJ
authors.lastname: Ho
authors.affiliation: Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Chi-Kong
authors.initials: CK
authors.lastname: Li
authors.affiliation: University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Lee-Lee
authors.initials: LL
authors.lastname: Chan
authors.affiliation: China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chang-Fang
authors.initials: CF
authors.lastname: Chiu
authors.affiliation: Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Pranee
authors.initials: P
authors.lastname: Sutcharitchan
authors.affiliation: Novartis Pharmaceuticals Corp, East Hanover, USA.
authors.forename: Dany
authors.initials: D
authors.lastname: Habr
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Gabor
authors.initials: G
authors.lastname: Domokos
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Bernard
authors.initials: B
authors.lastname: Roubert
authors.affiliation: Novartis Asia Pacific Pharmaceuticals, Singapore, Singapore.
authors.forename: Hong-Ling
authors.initials: HL
authors.lastname: Xue
authors.affiliation: Monash Medical Centre, Melbourne, Australia.
authors.forename: Donald K
authors.initials: DK
authors.lastname: Bowden
authors.affiliation: National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Kai-Hsin
authors.initials: KH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D001210:Asia, Southeastern; D001565:Benzoates / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D000077588:Deferasirox; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage*; D008297:Male; D013789:Thalassemia / Q000097:blood / Q000188:drug therapy*; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D005293:Ferritins; D000077588:Deferasirox